Pubdate: Sat, 3 Jun 2006
Source: New York Times (NY)
Copyright: 2006 The New York Times Company
Authors: Lawrence K. Altman and Elisabeth Rosenthal
Bookmark: (Harm Reduction)


UNITED NATIONS -- The General Assembly adopted a strongly worded 
declaration on Friday aimed at pressing the nations of the world to 
strengthen their battle against AIDS, a global pandemic that 
Secretary General Kofi Annan called "the greatest challenge of our generation."

The language of the document surprised even anti-AIDS groups, which 
said that while it did not satisfy all their objectives, they had 
feared it would be watered down. In turn, United Nations officials 
credited the advocacy groups for strengthening the draft in 
behind-the-scenes struggles during an extraordinary three-day plenary session.

The nonbinding declaration reaffirms commitments made in 2001, when 
the United Nations defined AIDS as far more than a medical issue, 
framing it in terms of politics, human rights and economic survival.

At the time, few felt that effective delivery of the antiretroviral 
therapy now provided to some people in poor countries was possible, 
and there was little money for the program.

The new document is a political blueprint, not a plan of action. It 
calls for a strong commitments to bolster the rights of women and 
girls so they can protect themselves from infection with H.I.V., the 
virus that causes AIDS. The document also acknowledges the role of 
men in spreading the disease and their responsibility to respect women.

The declaration calls on countries to use scientifically documented 
prevention strategies, including condoms; to make clean needles 
accessible to drug users; and to take steps to provide universal 
access to prevention programs, care and antiretroviral drugs.

It includes politically charged terms like "condoms" and "vulnerable 
groups," though those groups are not specified. Many advocates have 
urged the United Nations to acknowledge frankly that some of today's 
fastest-growing H.I.V. epidemics are among intravenous drug users, 
prostitutes and gay men.

Countries will be expected to measure their progress over the next 
five years against targets to be determined by the United Nations.

To achieve these and other goals, the declaration said, the world 
will need to spend up to $23 billion a year by 2010, almost triple 
the $8.3 billion spent last year. The challenge is for governments to 
follow through after delegates go home, the General Assembly's 
president, Ian Eliasson of Sweden, said at a news conference.

In the 25 years since the first case was discovered, AIDS has become 
one of the worst pandemics in history, infecting 60 million people 
and leading to 25 million deaths.

Earlier in the day, Mr. Annan delivered a gloomy assessment, saying 
the world was losing the battle.

"The epidemic continues to outpace us," he told a packed session of 
the General Assembly. "There are more new infections than ever 
before; more deaths than ever before; more women and girls infected 
than ever before."

His dark tone diverged markedly from the upbeat speeches by world 
leaders at the start of the three-day session on Wednesday, and from 
the positive speech given Friday morning by Laura Bush, the first lady.

Mrs. Bush said the United States contributed more money than any 
other country to fight AIDS, which "respects no national boundaries; 
spares no race or religion; and devastates men and women, rich and poor alike."

Mrs. Bush noted that her husband had put forth a plan in 2003 that 
contributes $15 billion over five years to fight AIDS internationally.

Her speech steered away from many of the criticisms that have been 
leveled against the administration, notably that it promotes sexual 
abstinence over scientifically proven strategies, particularly condom 
use. Indeed, she said, the "ABC" model -- the initials stand for 
abstain, be faithful and use condoms -- had brought sharp declines in 
infections in Africa.

Britain's secretary of state for international development, Hilary 
Benn, noting policy differences between his country and the United 
States, said in an interview that abstinence alone did not work.

Mr. Benn, whose country contributes the second-largest amount to 
fight AIDS, criticized the declaration for not spelling out the ways 
the virus is transmitted through sex and through contaminated needles 
used to inject drugs, and from mother to infant through birth and nursing.

"Abstinence is fine for those who are able to abstain, but human 
beings like to have sex and they should not die because they do have 
sex," Mr. Benn told the assembly.

Dr. Mark Dybul, the acting United States global AIDS coordinator, 
said in an interview that the United Nations had passed "a fine 
declaration" in which he had not found any weak points.

Adrienne Germain, president of the International Women's Health 
Coalition, said the document could be used "to make significant 
progress in going forward" in the fight.

But some advocacy groups said the document did not satisfy all their 

The Center for Health and Gender Equity, which says it represents 
nearly 70 international advocacy groups, denounced the document for 
failing to show greater political leadership; refusing to make a 
commitment to more definitive targets on financing, prevention, care 
and treatment; and rejecting frank acknowledgment that some of 
today's fastest-growing epidemics are occurring among injecting drug 
users, prostitutes and gay men.

Dr. Peter Piot, the executive director of the United Nations program, 
said that while no document could make anyone "100 percent happy," 
the final version was "a major advance" and far stronger than the 
weaker drafts circulating earlier in the week. 
- ---
MAP posted-by: Richard Lake